Search Results (5)

Developmental dysplasia of the hip, particularly Crowe type IV, presents significant challenges in orthopedic surgery due to severe anatomical deformities and biomechanical instability. This study focuses on evaluating the biomechanical performance of a prosthesis–femur–derotation plate system designed to address these challenges. Using FEA, a comprehensive assessment of stress distribution, displacement, and safety factors was conducted under physiological loading conditions. The derotation plate was specifically engineered to stabilize the femur and restore the anatomical and biomechanical axis of the limb. Results demonstrated that the derotation plate effectively eliminated rotational and axial displacement, with a peak displacement of 0.08 mm, and maintained sufficient strength reserves, with a minimum safety factor of 3.63. The maximum von Mises stress in the plate was 76 MPa, significantly below the yield strength of the titanium alloy, ensuring long-term durability and reliability. The system as a whole exhibited favorable biomechanical properties, confirming its ability to manage high stress loads without the risk of material failure or instability. These findings underscore the potential of this novel system to improve surgical outcomes in complex cases of hip dysplasia. Future clinical trials will further validate its practical utility, providing valuable insights for advancing orthopedic implant design and patient care. Full article

Background: Femoral torsional malalignment is a common cause of in-toeing and out-toeing in children, often leading to gait disturbances, functional limitations, and increased risk of falls. Traditionally, osteotomy was the only surgical option for correction. A minimally invasive technique known as rotational guided growth (RGG) has recently been introduced to address these malalignments. This study aims to assess the effectiveness of rotational femoral malalignment correction by rotational epiphysiodesis with tension band 8-plates (Orthofix, Verona, Italy). Methods: Eleven patients with in-toeing and out-toeing (19 femurs) were treated using RGG with 8-plates. The 8-plates were applied laterally and medially, with screws placed above and below the growth plate of the distal femur, angled obliquely to the long axis of the bone in opposite directions. Changes in foot progression angle (FPA), femoral version, the alteration in the angle between the 8-plates, and the rate of correction were recorded. Results: All patients reported functional gait improvement. The FPA was corrected from a mean of 32 degrees to 7 degrees, the femoral version improved from a mean of 60 degrees to 22 degrees. The angle between the 8-plates changed from a mean of 75 degrees to 28 degrees, with a correction rate of 4.1 degrees per month. The average time for correction was 11 months. No complications were observed during the treatment. Conclusions: RGG using 8-plates is a novel, minimally invasive surgical technique that effectively corrects rotational femoral deformities and may serve as a preferred alternative to derotational osteotomy in growing patients. Full article

Correction of rotational malalignments caused by fractures is essential as it may cause pain and gait disturbances. This study evaluated the intraoperative use of a smartphone application (SP app) to measure the extent of corrective rotation in patients treated using minimally invasive derotational osteotomy. Intraoperatively, two parallel 5 mm Schanz pins were placed above and below the fractured/injured site, and derotation was performed manually after percutaneous osteotomy. A protractor SP app was used intraoperatively to measure the angle between the two Schanz pins (angle-SP). Intramedullary nailing or minimally invasive plate osteosynthesis was performed after derotation, and computerized tomography (CT) scans were used to assess the angle of correction postoperatively (angle-CT). The accuracy of rotational correction was assessed by comparing angle-SP and angle-CT. The mean preoperative rotational difference observed was 22.1°, while the mean angle-SP and angle-CT were 21.6° and 21.3°, respectively. A significant positive correlation between angle-SP and angle-CT was observed, and 18 out of 19 patients exhibited complete healing within 17.7 weeks (1 patient exhibited nonunion). These findings suggest that using an SP app during minimally invasive derotational osteotomy can result in accurate correction of malrotation of long bones in a reproducible manner. Therefore, SP technology with integrated gyroscope function represents a suitable alternative for determination of the magnitude of rotational correction when performing corrective osteotomy. Full article

Background: Hip displacement in children with cerebral palsy (CP) has a higher prevalence in non-ambulatory children. Progression can lead to pain, pelvic obliquity and difficulty with sitting. This can be addressed with hip reconstruction. Our study aims to report the long-term radiological outcomes after hip reconstruction, in particular the evolution of femoral head deformity. Methods: A total of 58 hips of non-ambulatory children with CP were evaluated retrospectively using pre-operative, early (median 120 days) and late post-operative (median 8.6 years) anteroposterior standardised radiographs. All the hips were treated with femoral shortening varus derotation osteotomy (VDRO), pelvic osteotomy and an open reduction, if indicated. The radiographical indices measured included the migration percentage (MP), sharp angle, acetabular index, centre-edge angle, neck shaft angle, head shaft angle, pelvic obliquity, femoral head sphericity, femoral head deformity (FHD) and growth plate orientation. Results: Improvements in hip congruency and morphology were evident after reconstructive hip surgery. These were maintained at the late post-operative time point. Median MP improved from 56% (IQR 46–85%) to 0% (IQR 0–15%) at early follow-up. This increased to 12% (IQR 0–20%) at late follow-up. Pre-operatively, FHDs of 14 hips (24%) were classified as grade A (spherical femoral head). This increased to 22 hips (38%) at early follow-up and increased further to 44 hips (76%) at late follow-up. Conclusions: Our study shows that hip reconstruction reduces hip displacement in the long term, indicated by decreased post-operative MP maintained at long-term follow-up. Although non-ambulatory children lack weight-bearing forces promoting bone remodelling, improved femoral head morphology after surgery alters the forces between the acetabulum and the femoral head. Mild femoral head deformity (grades A and B) remained stable and even improved after surgery, postulated to be due to severe osteoporosis allowing remodelling. Full article

The main challenge of automatic license plate recognition (ALPR) systems is that the overall performance is highly dependent upon the results of each component in the system’s pipeline. This paper proposes an improved ALPR system for the Jordanian license plates. Ceiling analysis is carried out to identify potential enhancements in each processing stage of a previously reported ALPR system. Based on the obtained ceiling analysis results, several enhancements are then suggested to improve the overall performance of the system under study. These improvements are (i) vertical-edge histogram analysis and size estimation of the candidate regions in the detection stage and (ii) de-rotation of the misaligned license plate images in the segmentation unit. These enhancements have resulted in significant improvements in the overall system performance despite a <1% increase in the execution time. The performance of the developed ALPR is assessed experimentally using a dataset of 500 images for parked and moving vehicles. The obtained results are found to be superior to those reported in equivalent systems, with a plate detection accuracy of 94.4%, character segmentation accuracy of 91.9%, and character recognition accuracy of 91.5%. Full article